Physiotherapy for climbers

Due to the nature of climbing, injuries most commonly occur in the upper limbs. The muscles, joints and tendons of the upper limbs are susceptible to injury due to high loads put on them.

The act of climbing can also lead to muscle imbalance which will affect your posture and can lead to compensatory pain. This may occur in the neck, upper back and shoulders.

Climbing Hand Injuries

With excessive climbing injuries can occur as a result of overuse. Climbing repeatedly on bad holds can lead to a tendon pulley injury. Pulleys in our hands are ligaments which guide the movement of tendons and an injury will cause pain and sometimes swelling/bruising on the palm side of your finger. There are 3 different grades in respect to pulley injuries; Grade 1, 2 and 3:

Grade 1 - A sprain of the ligaments in the finger (collateral ligaments) which elicits pain at the pulley and pain when squeezing the hand or trying to climb.

Grade 2 - A partial rupture to the pulley. Symptoms very much like a grade one strain but further pain when extending (straightening) your finger.

Grade 3 - A complete rupture of the pulley. This causes a bowstring effect to the tendon. Symptoms include sharp pain to the pulley and the climber may have heard or felt a 'crack'. Further symptoms include swelling and bruising to the hand, and pain with any resisted movement to the hand and fingers.

Further injuries related to overuse when climbing can include trigger finger. Trigger finger is where the affected finger is bent towards the palm with the affected tendon getting stuck and locking. It occurs if there is swelling or inflammation with the tendon or sheath, causing the tendon to no longer be able to easily slide through the sheath and become bunched up to form a nodule.

Climbing Elbow Injuries:

Pain on the inside of your elbow is typically known as golfer's elbow where pain on the outside is often known as tennis elbow. Both of these types of injury can be caused by climbing because of the repeated and excessive training loads which result in a breakdown in the muscle/tendon complex. This will restrict your grip strength and be very painful, causing you to stop climbing.

Climbing Shoulder Injuries.

Shoulder dislocation is very common in climbing due to the joint itself being designed more for mobility than stability. The shoulder joint gains its stability from the ligaments and rotator cuff muscles. When the rotator cuff muscles are weak and lack control, the stability of the shoulder is compromised. In climbing there are excessive forces put through the shoulder joint, increasing the risk of dislocation.

When your shoulder dislocates it is also common to tear part of the cartilage (labrum). The most common cartilage tear in climbing in a SLAP lesion. The mechanism of a SLAP tear is excessive traction on the labrum through the biceps tendon (climbing). This involves the top part of the cartilage tearing from the front to back where the biceps tendon attaches. SLAP lesions are either stable or unstable, depending on the extent of the tear and how firmly the biceps tendon is attached to the labrum. Symptoms include a deep shoulder pain with sensations of catching when moving your arm. The extent can be determined through a thourough examination from your physiotherapist.

Rotator cuff injuries are also common in climbers. The rotator cuff muscles and tendons surround the shoulder joint providing stability and movement, (gleno-humeral joint) they can be injured by a sudden force or repetitive loading over a sustained period of time with insufficient rest (over training). In severe cases a rotator cuff injury may require surgery but in many cases physiotherapy management is the most effective form of treatment. Physiotherapy can involve a period of relative rest, deep tissue massage, joint mobilisation and progressive strength exercises to enable a return to climbing. Your physiotherapist will also be to help you with exercises specific to climbing and cross training exercises which will enable you maintain strength and fitness during the rehabilitation process.

Can Physiotherapy Help With My Climbing Injuries?

Yes, a physiotherapist will be able to complete a thorough assessment to ascertain the cause/extent of the injury. Depending on the nature of the injury, the physiotherapist will then be able to provide you with professional advice and a course of treatment. It may initially involve a period of rest from climbing to allow the tissue to repair. If the extent of the injury is too severe, the physiotherapist will refer you to the relevant health professional for further treatment/advice. A combination of manual therapy, a program of stretches and strengthening exercises will also be used.

When returning to climbing after injury it is important to ensure the injured tissue is capable of the forces that it will be exposed to. The physiotherapist will guide you through a course of rehabilitation exercises specific to climbing, focusing on body weight exercises and progressing in line with the tissues healing process. Once the physiotherapist feels you are fit to return to climbing they will advice you on how you can wean yourself back to the sport without injuring yourself further.